Provider Demographics
NPI:1437233699
Name:SANTIAGO FORTIER, AURELIO (MD)
Entity type:Individual
Prefix:DR
First Name:AURELIO
Middle Name:
Last Name:SANTIAGO FORTIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 670
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0670
Mailing Address - Country:US
Mailing Address - Phone:787-864-6754
Mailing Address - Fax:
Practice Address - Street 1:26 CALLE ASHFORD N
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-4608
Practice Address - Country:US
Practice Address - Phone:787-864-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5484208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics